缬沙坦联合阿托伐他汀对早期糖尿病肾病患者hs—CRP、LDL-C、SCr水平及肾功能的影响

Effects of Valsartan Combined with Atorvastatin on hs-CRP, LDL-C and SCr Levels and Kidney Function of Patients with Early Diabetic Nephropathy

【目的】探讨缬沙坦联合阿托伐他汀对早期糖尿病肾病（DN）患者超敏C反应蛋白（hs—CRP）、血肌酐（SCr）、低密度脂蛋白胆固醇（LDL-C）水平及肾功能的影响。【方法】本院选取2013年6月至2016年10月就诊的DN患者92例，随机分为观察组和对照组，每组46例。对照组给予单纯缬沙坦治疗，观察组在对照组基础上加用阿托伐他汀治疗，比较两组治疗前后hs—CRP、SCr、LDL—C水平、肾功能指标[β2-微球蛋白（β2—MG）、肾小球滤过率（GFR）、尿白蛋白排泄率（UAER）]及不良反应发生率。【结果】两组患者治疗前hs—CRP、SCr及LDL—C水平比较差异无统计学意义（P〉0．05）；治疗后，两组hs-CRP、SCr及LDL—C水平均下降，且观察组下降更显著，其差异均有统计学意义（P〈0．05）。两组患者治疗前UAER、β2-MG、GFR比较差异无统计学意义（P〉0．05）；两组患者治疗后UAER、G2-MG及GFR均下降（P〈0．05），观察组UAER、β2-MG下降更显著（P〈0．05），但两组患者治疗后GFR比较差异无统计学意义（P〉0．05）。观察组不良反应发生率为19．57％（9／46），显著低于对照组的36．96％（17／46），其差异具有统计学意义（P〈0．05）。【结论】缬沙坦联合阿托伐他汀治疗早期DN患者，可降低有效hs—CRP、SCr及LDL-C水平，改善肾功能，降低不良反应发生率，值得临床推广应用。

[Objective]To discuss effects of valsartan combined with atorvastatin on hs-CRP, LDL-C and SCr levels and kidney function of patients with early diabetic nephropathy. [Methods]From June 2013 to October 2016, 92 patients with DN were randomly divided into observation group and control group with 46 cases in each group. The control group was treated with valsartan alone, the observation group was treated with atorvastatin on the basis of the control group, and the LDL-C levels of hs-CRPN SCr were compared between the two groups before and after treatment. Renal function index and incidence of adverse reactions. The levels of hs-CRP, LDL-C, renal function indexesβ2-MG , GFR , UAER and incidence of adverse reaction were compared between the two groups before and after treatment. [Results]There was no significant difference in the levels of hs-CRP, SCR and LDL-C between the two groups before treatment （ P 〉0.05）. Af ter treatment, the levels of hs-CRP, SCR and LDL-C decreased significantly in the two groups, and the difference was statistically significant （ P 〈0.05 ）. There was no significant difference in UAER, ]]2-MG and GFR between the two groups before treatment （ P 〉0.05）. After treatment, UAER, β2-MG and GFR decreased in both groups （ P 〈0.05）. UAER, β2-MG decreased significantly in the observation group （ P 〈0.05）. However, there was no significant difference in GFR between the two groups after treatment （ P 〉0.05）. The incidence of adverse reactions in the observation group was 19.57 % （9/46）, which was significantly lower than that in the control group 36.96 % （ 17/46 ）, the difference was statistically significant （ P 〈0.05）. [Conclusion]Valsartan combined with Atovastatin in the treatment of early DN pa- tients can effectively reduce the levels of hs-CRP, SCr and LDL-C, improve renal function and reduce the incidence of adverse reactions, which is worthy of clinical application.